| NPI | 1427158062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-23061) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 05-23061) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2014-11-13 |